Author Affiliations: Molecular and Cell Biology Laboratory, Istituto Dermopatico dell'Immacolata, Istituto di Ricovero e Cura a Carattere Scientifico (IDI-IRCCS), Rome, Italy (Drs Di Zenzo and Zambruno); Department of Dermatology, Rouen University Hospital, University of Rouen, Rouen, France (Dr Joly); and Department of Dermatology, University Hospital –Inselspital, Berne, Switzerland (Dr Borradori).
We read with interest the Practice Gap comments of Dr Chan published in the March issue of the Archives.1 We agree that there is a lack of consensus on diagnostic criteria for bullous pemphigoid (BP) and a need to provide better information in this area. However, the author's recommendation to routinely perform the commercially available enzyme-linked immunosorbent assay (ELISA) for BP180 instead of using indirect immunofluorescence (IIF) microscopy studies on a split-skin sample for the diagnosis of BP cannot be fully supported.
Di Zenzo G, Joly P, Zambruno G, Borradori L. Sensitivity of Immunofluorescence Studies vs Enzyme-Linked Immunosorbent Assay for Diagnosis of Bullous Pemphigoid. Arch Dermatol. 2011;147(12):1454–1456. doi:10.1001/archderm.147.12.1454-b
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